South Seattle Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DE00010347 Issued in WA

Legal business name

SOUTH SEATTLE DENTAL

Practice address

12616 Renton Ave S
Seattle, WA 98178-3711

Phone

(206) 772-6068

Fax

(206) 772-1231

NPI assigned

Sep 6, 2009

Last updated

Sep 6, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Harry LauNPI 1649478900

Title

Owner

Phone

(206) 772-6068

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Harry Hon-Lin Lau, DDS

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1649478900
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252195200000",
    "number": "1790018976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12616 RENTON AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783711",
            "telephone_number": "206-772-6068",
            "fax_number": "206-772-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12616 RENTON AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783711",
            "telephone_number": "206-772-6068",
            "fax_number": "206-772-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SEATTLE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-06",
        "last_updated": "2009-09-06",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-772-6068",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00010347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5054291",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parham Souri
• Manuela M Sousa, M.D.
• Karen Jane Souter
• Michael James Souter
• South Rainier Dentistry, PLLC (south rainier dentistry)
• South Seattle Therapy, PLLC
• South Sound Inpatient Physicians PLLC (Sound Inpatient Physicians)
• South Sound Laser Services LLC
• Allen Gregg South, M.D.
• Southeast Youth and Family Services

• Dental Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.